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Vagus Nerve Stimulation and Lennox-Gastaut Syndrome: A Review of the Literature and Data From the VNS Patient Registry

Published online by Cambridge University Press:  07 November 2014

Steven Karceski
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Abstract

Lennox-Gastaut syndrome (LGS) is a severe form of childhood epilepsy that is usually refractory to medical management. When medications fail, alternative therapies are considered. Among these are two surgical options: corpus callosotomy and vagus nerve stimulation (VNS). Safety and efficacy are two important factors to consider when selecting an appropriate treatment. VNS is safer than callosotomy, but its efficacy is more difficult to assess. Available studies evaluate its effectiveness using a mixed population of patients (some with prior epilepsy surgery), a multitude of VNS settings, and variable endpoints. To estimate the efficacy of VNS in patients with LGS, a review of the medical literature and the VNS Patient Registry was performed. Within the limits of this type of study, the results showed that VNS appears equally as effective as callosotomy. Because VNS has a lower potential for adverse events, these results suggest that VNS should be considered first in appropriately selected patient.

Type
Original Research
Information
CNS Spectrums , Volume 6 , Issue 9: Epilepsy: Diagnosis and Treatment in the 21st Century , September 2001 , pp. 766 - 770
Copyright
Copyright © Cambridge University Press 2001

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References

REFERENCES

1. Genton, P, Dravet, C. Lennox-Gastaut Syndrome and other childhood epileptic encephalopathies. In: Engel, J, Pedley, TA, eds. Epilepsy: A Comprehensive Textbook. Philadelphia, Pa: Lippincott-Raven Publishers; 1997: 2355–2366.Google Scholar
2. Benbadis, S, Tatum, W, Vale, F. When drugs don't work: an algorithmic approach to medically intractable epilepsy. Neurology. 2000;55:1780–1784.CrossRefGoogle ScholarPubMed
3. Hosain, S, Nikalov, B, Harden, C, et al.Vagus nerve stimulation treatment for Lennox-Gastaut syndrome. J Child Neurol. 2000;15:509–512.CrossRefGoogle ScholarPubMed
4. Schmidt, D, Bourgeois, B. A risk-benefit assessment of therapies for Lennox-Gastaut Syndrome. Drug Saf. 2000;22:467–477.CrossRefGoogle ScholarPubMed
5. Rougier, A, Claverie, B, Pedespan, JM, Marchal, C, Loiseau, P. Callosotomy for intractable epilepsy: overall outcome. J Neurosurg Sci. 1997;41:51–57.Google ScholarPubMed
6. Wyllie, E. Corpus callosotomy for intractable generalized epilepsy. J Pediatr. 1988;113:255–261.CrossRefGoogle ScholarPubMed
7. Dulac, O, Nguyen, T. The Lennox Gastaut syndrome. Epilepsia. 1993;34 (suppl 7):S7–S17.CrossRefGoogle ScholarPubMed
8. Spencer, D, Spencer, S. Corpus callosotomy in the treatment of medically intractable secondarily generalized seizures of children. Cleve Clin J Med. 56(suppl 1):S68–S83.Google Scholar
9. Vining, E. Ketogenic diet. In: Engel, J, Pedley, TA, eds. Epilepsy: A Comprehensive Textbook. Philadelphia, Pa: Lippincott-Raven Publishers; 1997:1339–1344.Google Scholar
10. Roberts, D. Corpus callosotomy. In: Engel, J, Pedley, TA, eds. Epilepsy: A Comprehensive Textbook. Philadelphia, Pa: Lippincott-Raven Publishers; 1997:1851–1858.Google Scholar
11. Vagus Nerve Stimulation Group. A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. Neurology. 1995;45:224–230.CrossRefGoogle Scholar
12. Ramsay, RE, Uthman, BM, Augustinsson, LE, et al.Vagus nerve stimulation for treatment of partial seizures: 2. safety, side effects, and tolerability. First International Vagus Nerve Stimulation Study Group. Epilepsia. 1994;35:627–636.CrossRefGoogle ScholarPubMed
13. Crumrine, P, Foley, C, Adelson, P. Vagal nerve stimulation in a pediatric population [abstract]. Epilepsia. 1999;40 (suppl 7):169.Google Scholar
14. Frost, M, Gates, JR, Conry, JA, et al.Vagus nerve stimulation (VNS) in Lennox-Gastaut Syndrome (LGS) [abstract]. Epilepsia. 1999;40(suppl 7):95.Google Scholar
15. Frost, M, Hoskin, C, Moriarty, GL, et al.Use of the vagus nerve stimulator in patients who have failed epilepsy surgery [abstract]. Epilepsia. 1998;39(suppl 66):192.Google Scholar
16. Garcia-March, G, Bordes, V, Talamantes, G, et al.Vagus nerve stimulation for the control of medically resistant epilepsy. Epilepsia. 1999;40(suppl 2):89.Google Scholar
17. Hosain, SA, Harden, C, Nikolov, BG, et al.Vagus nerve stimulation in children with Lennox-Gastaut Syndrome: a one-year outcome [abstract]. Epilepsia. 2000;41(suppl 7):183.Google Scholar
18. Likasitwattanakul, S, O'Donovan, CA, Sam, MC, et al.Effectiveness of vagus nerve stimulator in patient who have failed surgery [abstract]. Epilepsia. 1999;40(suppl 7):110.Google Scholar
19. Lobo, S, Davies, KG, Phillips, LB, et al.Vagus nerve stimulation for intractable epilepsy in children: a series of 18 patients [abstract]. Epilepsia. 1999;40(suppl 7);206.Google Scholar
20. Nezedal, T, Hovorka, J, Zivny, B, et al.Vagus nerve stimulation in patients with refractory epilepsy [abstract]. Epilepsia. 1999;40(suppl 7):90.Google Scholar
21. Paolicchi, J, Tsao, C-Y. The effectiveness of VNS in pediatric patients with medically intractable epilepsy [abstract]. Epilepsia. 2000;41(suppl 7):178.Google Scholar
22. Topcu, M, Turanli, G, Yalnizoglu, D, et al.Vagus nerve stimulation in childhood onset refractory epilepsy: seizure outcome and neurological evaluation [abstract]. Epilepsia. 2000;41(suppl 7):188.Google Scholar
23. Wheless, J, Helmers, S, Frost, M, et al.Vagus nerve stimulation (VNS) in children: efficacy [abstract]. Epilepsia. 1999;40(suppl 7):120.Google Scholar
24. Whitworth, L, Kanos, C, Montouris, G, et al.Vagus nerve stimulation for intractable epilepsy: a series of 50 patients operated on at one center and with comparison of two cycle types [abstract]. Epilepsia. 1999;40(suppl 7):240.Google Scholar
25. Yalnizoglu, D, Helmers, S, Madsen, S. Vagal nerve stimulation in children with medically intractable epilepsy following epilepsy surgery [abstract]. Epilepsia. 1999;40(suppl 7):120.Google Scholar
26. Ben-Menachem, E, Hellstrom, K, Waldton, C, et al.Evaluation of refractory epilepsy treated with vagus nerve stimulation for up to 5 years. Neurology. 1999;52:1264–1267.CrossRefGoogle ScholarPubMed
27. Hornig, G, Murphy, JV, Scallert, G, et al.Left vagus nerve stimulation in children with refractory epilepsy. South Med J. 1997;90:484–488.CrossRefGoogle ScholarPubMed
28. Lundgren, J, Amark, P, Blennow, G, et al.Vagus nerve stimulation in 16 children with refractory epilepsy. Epilepsia. 1998;39:809–813.CrossRefGoogle ScholarPubMed
29. Parker, P, Polkey, CE, Binnie, CD, et al.Vagus nerve stimulation in epileptic encephalopathies. Pediatrics. 1999;103:778–782.CrossRefGoogle ScholarPubMed
30. Labar, D, Murphy, J, Tecoma, E. Vagus nerve stimulation for medication-resistant generalized epilepsy. EO4 VNS Study Group. Neurology. 1999;52:1510–1512.CrossRefGoogle Scholar